Speaker to Have Surgery Today for MDR-TB

DENVER, July 17 -- Andrew Speaker's much-documented battle with drug-resistant tuberculosis took another a turn today, with the sudden announcement that he would have surgery this morning to remove diseased and damaged lung tissue.

Plans to operate on the 31-year-old Atlanta lawyer had been put "on hold" after physicians found that his original diagnosis of extensively drug resistant TB (XDR-TB) was instead had the slightly more treatable multi-drug resistant form of the disease (MDR-TB).

Because the new diagnosis widened antibiotic treatment options, Speaker's doctor -- Charles Daley, M.D., of National Jewish Medical and Research Center here - said that he and colleagues would "revisit" the surgical option after they saw how well he responded to therapy.

But National Jewish said today that "after consultation with his physicians," Speaker had decided to undergo surgery without waiting. The surgery was to be performed by John Mitchell, M.D., chief of general thoracic surgery at the University of Colorado Hospital, National Jewish said.

Speaker was at the heart of an international furor after he traveled to Europe and back with what authorities then thought was XDR-TB. The CDC used powers under the federal Public Health Act to isolate the man - the first time in four decades it had done so - and the case caused a media firestorm.

Dr. Mitchell planned to perform minimally invasive video-assisted thoracic surgery (VATS), in which access to the lung is obtained through one two-inch incision in the side, as well as two 1-cm incisions for surgical instruments and a fiberoptic camera.

He was to switch to a standard thoracotomy if he found that the VATS technique was not feasible or did not provide adequate access to the infected portion of the lung, the hospital said.

"This type of surgery requires that we take special care to contain any infected tissue removed, and that we identify and completely resect any spread of the infection to the chest wall," Dr. Mitchell said in a statement.

"Given the localized nature of the disease, I am optimistic about the chances for a successful surgery," he said.